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PROOF OF INSURANCE (2023 - 2024) CLOSED
dd CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/21/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Aon Risk Services South, Inc. ITHONMJA�nITITITITmmITITmmITIT(_ _ 866) 283-7122-- __ITITmmITITmmIT ITF^xITITITITITITITITITITIT(800) 363-0105 Franklin TN Office IAM,nIn,Exz@r N:^ E-MAIL 501 Corporate Centre Drive Suite 300 ADDRESS: Franklin TN 37067 USA INSURER(S) AFFORDING COVERAGE NAIC p INSURED INSURERA: Hartford Fire Insurance CO. '.19682 Arcadis, a California Partnership INSURERB: Hartford Accident & indemnity Company 22357 537 South Broadway, Suite 500 Los Angeles CA 90013 USA INSURERC: Twin City Fire Insurance Company 29459 INSURER D: INSURER E: ._............................................................................................................. INSURERF: COVERAGES CERTIFICATE NUMBER: 570101622415 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Liml'to shown are, as m uestBd INS R TYPE OF INSURANCE ADDS SOUR' wvn POLICY NUMBER POLICY EFF POLICY EXPTR LIMITS A COMMERCIAL GENERAL LIABILITY Y. '' 20ECSOL5319 4 1 EACH OCCURRENCE $1,000,000 CLAIMS OCCUR SIR applies per policy to s & condi Jons DAMAGE TO RENTED S1,000,000 -MADE �l PRF,M,,1S„,,4 an�CAsrrencel MED EXP (Any one person) $10, 000 d _.................................................................................................................................................. .................................�......._........� PERSONAL &ADV INJURY $1,000,00 CrENI ACGRFGATE APPL.AES' PER, GENERAL AGGREGATE $2 , 000, 000 ""LjIMa POLICY II x IJEC LOC �A PRODUCTS - COMP/OP AGO $2,000,000 OTHER: A AUTOMOBILE LIABILITY 20 LIEN OL5319 04/30/2023 10/01/2023 COMBINED SINGLE LIMIT $1,000,000 X ANYAUTO BODILY INJURY( Per person) BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED PROPERTY DAMAGE ^-^^^^^^^^^^^ ONLY AUTOS ONLY Per atxidenl. UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RIET'ETrF'ON B WORHERSCOMPENSATIONAND 2OWNOL5323 04/30/2023 10/01/2023 X PERSTATUTE OTH- _... R EMPLOYERS' LIA,SUL1TY' M NLN A ACCIDENT E L EACH ACC $1,000,000 C ANY PROPRIETOR / PARTNER / EXECUTIVE 20WBROL5321 04/30/2023 10/01/2023 OFFICERIMEMBEREXCLUDED? (Mandatory in NH) N/A MA, WI _._._._ mm, E.L DISEASE -EA EMPLOYEE $1,000,00CV If yes, deseribe under DESCRIPTION OF OPERATIONS helm E L DISEASE -POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Engineering and Architechtural detail and Design and Consultant Services for the Urho Saari Swim Stadium. The City of El Segundo, its officials and employees are included as Additional Insured in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS., City of El Segundo AUTHORIZED REPRESENTATIVE Attn: Elias Sassoon 350 Main St. El Sequndo CA 90245 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks ofACORD C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 110 0413 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 09/21/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME:, Aon Risk Services South, Inc. PHONE (866) 263 7122 FPx (600) 363-0105 (� Cu•Ext)µ ac.Ne.: .-.................................. Franklin TN office 501 Corporate Centre Drive E-MAIL Suite 300 ADDRESS: Franklin TN 37067 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED __............................ INSURER A:: Indian Harbor Insurance Company 36940 Arcadis, a California Partnership ............._....__.�............ _.��................................................. 537 South Broadway, Suite 500 IINSURER B: ......-•-•---------..... ........ •----•-•-••••......_-- Los Angeles CA 90013 USA ''. INSURER C: INSURER D: ......... ................_............ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570101622429 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM$ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Limits shown are as reuested INSn TYPE OF INSURANCE ADOL INqO "SUBR WVO POLICY NUMBER POLICYEFF fMMfnONYYY1 POLICY EXp IMM0UOIYYyyl, LIMITS COMMERCIALGENERALLUIBILITY EACH OCCURRENCE CLAIMS-MADE OCCUR OAWYAG.k 1O REN"J4'0� PI" ,MPS 4,.p'. Irv:;aa»reearc�Rf' .� MED EXP (Any one person) PERSONAL& ADV INJURY GE.IgLAIGG'R5EGAI E L➢ NT APFILI F 9 Pr.R. GENERAL AGGREGATE POLICY PRO- LOC ..... .... .................._ JEIC1 I PRODUCTS- COMP/OPAGG ()DiER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JUa%a=L__ BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUT05 NON -OWNED ..... -•-----....-.-.. PROPERTY DAMAGE ONLY AUTOS ONLY Pe ccident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LWB CLAIMS -MADE DED I ''..RIET"ENTION WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS' LIABILT' tl I N ......_........................._,...�.�...... .......... .�...... ANY PROPRIETOR / PARTNER / EXECUTIVE E L EACH ACCIDENT OFFICERIMEMBER EXCLUDED? E,NIA E L DISEASE -EA EMPLOYEE (Mandatary In NH) Ifyes, describe under •-•--•__._._._.—•_.-- •— _,_ •- .• ����--------...... DFSCRIPTION OF OPERATIONS below 11 E.L DISEASE -POLICY LIMIT A Contractors Pollution US00101061EO23A 06/01/2023 06/01/2024'Each Claim $1,000,00 Liability Professional & Pollution Annual Aggregate $1,000,000 SIR applies per policy ter s & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H mare space is required) For Professional Liability and Pollution Liability coverage, the Aggregate Limit is the total insurance available for claims presented within the policy period for all operations of the insured. The Limit will be reduced byy payments of indemnity and RE: Engineering and Architechtural detail and Design Consultant Services for the urho Saari Swim Stadium. expense. and CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, City Of El Segundo AUTHORIZED -REPRESENTATIVE Attn: Elias Sassoon 350 main St. E1 Sequndo CA 90245 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks ofACORD AGENCY CUSTOMER ID: 570000005571 LOC Ii: . - ADDITIONAL REMARKS SCHEDULE '�..-•-��"" Page _ of _ AGENCY NAMEDINSURED Aon Risk services south, Inc. Arcadis, a California Partnership POLICY NUMBER See certificate Number: 570101622429 CARRIER I NAIC CODE see certificate Number: 570101622429 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits.. INSR LTR TYPEOFINSURANCE IADDL ''.. INSD SUBR WVD POLICYNUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MMMDIYYYY) LIMITS OTHER I FTms-made Fp ution Liability I Contractors gtr essional Liability ACORD 101 (2000101) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD